Clinical Edge

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ADSTEP May Increase Walking in Persons with MS

Arch Phys Med Rehab; 2018 Oct; Martini, et al

The Assistive Device Selection, Training and Education Program (ADSTEP), a multicomponent walking aid program, prevents falls, reduces sitting, and may increase walking in persons with multiple sclerosis (PwMS), a recent investigation found. Participants (n=40) were randomly assigned to ADSTEP or control. ADSTEP had 6 weekly, 40-minute, 1-on-1 sessions with a physical therapist, starting with walking aid selection and fitting, followed by task-oriented progressive gait training. Control was usual medical care with the option of ADSTEP after the study. The following were assessed at baseline, intervention completion, and 3 months later: falls, Timed Up and Go, timed 25-foot walk, 2-minute walk, Four Square Step Test, International Physical Activity Questionnaire, Quebec User Evaluation of Satisfaction with Assistive Technologies, Multiple Sclerosis Walking Scale-12, Activities-Specific Balance Confidence Scale, and Multiple Sclerosis Impact Scale-29. Researchers found:

  • Fewer ADSTEP than control participants fell (χ2=3.96, number needed to treat=3.3).
  • Time spent sitting changed significantly with ADSTEP than with control from baseline to intervention completion and to 3-month follow-up.
  • ADSTEP yielded a moderate effect on time spent walking compared to control at

3-month follow-up.


Martini DN, Zeeboer E, Hildebrand A, Fling BW, Hugos CL, Cameron MH. ADSTEP: Preliminary investigation of a multicomponent walking aid program in people with multiple sclerosis. Arch Phys Med Rehab. 2018;99(10):2050–2058. doi:10.1016/j.apmr.2018.05.023.

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